Kids Winter Day Camp Registration

top of page

HOURS / ADMISSION / CONTACT

Membership >>

HOME
SUPPORT US
VISIT
CONNECT
EVENTS
DONATIONS
EDUCATIONAL PROGRAMS
WEDDINGS / RENTALS
SHOP
ABOUT US
More

Use tab to navigate through the menu items.

KIDS WINTER DAY CAMP REGISTRATION

2023 Kids Winter Day Camp Registration - Now open!

Camp registration form

*Required

Payment

You should only be accessing this page after submitting online payment.

If you have not paid for your camp dates yet, please do not complete this form until after doing so. Pay for camp at our online store here. Payment must be received to confirm your place and complete registration.

2023 Kids Winter Day Camp Registration

Section 1: Camper Information

(Please complete a separate form for each camper you are registering)

Camper Last Name

Camper First Name

Age

Date of Birth

Gender

Male

Female

Camper's Primary Street Address

City

State

Zip Code

Section 2: Parent/Guardian Information

(This person will serve as the primary contact; they are also the primary emergency contact & they are an authorized driver)

Parent/Guardian Last Name

Parent/Guardian First Name

Relation to Camper

Email for Confirmation

How did you hear about Beech Creek Adventure Camp?

Primary Phone

Type

Secondary Phone

Type

Different Residence than Camper?

Yes

If yes, complete address below

Parent/Guardian Street Address

City

State

Zip Code

Section 3: Additional Parents/Guardians & Emergency Contact Information

(Please provide at least one additional emergency contact in this section, different than the primary contact listed above)

Last Name

First Name

Relation to Camper

Authorized Driver?

Yes

Primary Phone

Type

Secondary Phone

Type

Emergency Contact?

Yes

Last Name

First Name

Relation to Camper

Authorized Driver?

Yes

Primary Phone

Type

Secondary Phone

Type

Emergency Contact?

Yes

Last Name

First Name

Relation to Camper

Authorized Driver?

Yes

Primary Phone

Type

Secondary Phone

Type

Emergency Contact?

Yes

Section 4: Camper Health & Medical Information

(Select all that apply)

Allergies:

Foods

Hay Fever

Insects

Drugs

Animals

Other